Another limitation is that the models employed in this analysis did not adjust for possible psychiatric co-morbidity in parents. Hence it is possible that the effects seen in some disorders may have been mediated through an interaction between parental alcoholism and a co-morbid disorder or by the co-morbid disorder itself. Indeed, comprehensive measures of family histories of psychiatric disorders were not used in the current study, and this absence represents a limitation given the frequent co-occurrence of substance-related and non-substance related psychiatric disorders (e.g. Grella et a. 2009). Another limitation is that the existing data may not allow for a clear distinction to be made between substance-induced and primary psychiatric symptoms in. Nevertheless, the findings suggest that it could be beneficial to identify daughters of women with alcohol use disorders through screening, and that intervention based on the expectation of a predilection toward externalizing disorders may be particularly helpful. Specifically, when intervention in the parent is possible, it has been observed that interventions aimed at strengthening parent-child relations may be less effective than those aimed at reducing parent substance use
